A multivariate analysis of determinants of wound healing in patients

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after amputation for peripheral vascular disease. van-den-Broek-T-A. Dwars-B-J. Rauwerda-J-A. Bakker-F-C. Eur-J-Vasc-Surg. 1990 Jun. 4(3). P 291-5. In a prospective study 53 patients undergoing amputations of the lower limb were evaluated for clinical criteria, laboratory results, pulse volume recordings, Doppler pressures, Photoplethysmographic Skin Perfusion Pressures (PPG/SPP) and angiography. The purpose of the study was to analyse which of these techniques predicts wound healing adequately after amputation. Forty-five patients eventually completed all tests. With the exception of PPG/SPP none of these tests were able to predict skin healing. The technique [m of PPG/SPP proved very reliable in helping to select the level of amputation, if measured anteriorly (P = 0.0001, r = 0.83). Angiographic scoring also correlated significantly (P = 0.0016) with a successful result. This study suggests that surgeons should not rely on their clinical acumen for the selection of the amputation [m level. In the absence of a reliable non-invasive test, angiography may well be useful but PPG/SPP will enable the surgeon to amputate on an optimal level and thus reduce complications and improve rehabilitation. Author-abstract.